ED Coding and Reimbursement Alert

Also, remember the symbols that accompany new codes.

ED coders have been getting hammered with changes recently; the new ED evaluation and management (E/M) code descriptors, changes to other outpatient E/M services, ICD-10 codes, fee schedule proposals, etc.

And now, there’s CPT^® 2023 to deal with.

Don’t worry: Considering all the other changes coders have had to absorb lately, this one’s relatively small. Check out the changes you’ll want to know about before CPT^® 2023 takes effect on Jan. 1, 2023.

Note These Ultrasound Changes for Next Year

The codes that ED coders will need to familiarize themselves with before the end of the year all deal with ultrasound (US). The codes reside in the Diagnostic Ultrasound section of CPT^®, which currently runs from 76506 (Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including A-mode encephalography as secondary component where indicated) through 76999 (Unlisted ultrasound procedure (eg, diagnostic, interventional)).

More specifically, the codes you’ll want to focus on are under the Extremities subhead in the Diagnostic US section. There’s a single new code in the group: 76883 (Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity). This code will add to the codes for US of the extremities.

There’s also a code in the Extremities section that will be revised next year. (On revised codes, strikethroughs denote what’s being deleted from 2022 definition; underlines denote what’s being added for 2023 definitions). That code is 76882 (Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation).

So, in 2023, the Extremities section of Diagnostic Ultrasound will look like this:

• 76881 (Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation)
• 76882
• 76883
• 76885 (Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation))
• 76886 (… limited, static (not requiring physician or other qualified health care professional manipulation))

Impact: The addition of “focal evaluation” to 76882 will make it easier to successfully report this code if your provider uses this technique. The 76883 specifies that you are performing US throughout the patient’s “entire anatomic course in one extremity,” per the descriptor.

Symbolism 101: Remember These Rules for Code Keys

If a code is new, revised, or resequenced in CPT^® 2023, it will be accompanied by a symbol to the left of the code to indicate that fact. Here’s a breakdown of the symbols you’ll need to know to decipher coding changes in the CPT^® book:

▲: The blue triangle symbol indicates a revised code.

●: The red circle symbol indicates a new code.

#: The hash tag indicates a resequenced code.